Individual
DR. SAMUEL GREGORY BENANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
805 IVY AVE STE B, TILLAMOOK, OR 97141-3758
(503) 842-2356
(503) 815-2636
Mailing address
PO BOX 489, TILLAMOOK, OR 97141-0489
(503) 842-3900
(503) 842-3903
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7339
KY
1223G0001X
General Practice Dentistry
Primary
D10631
OR
Other
Enumeration date
09/20/2006
Last updated
10/20/2020
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